Trocar assembly with radially moveable housing

ABSTRACT

A surgical access assembly includes a cannula, a housing mounted to the cannula, and a seal disposed within the cannula. The cannula is adapted for insertion through tissue to permit access to an underlying tissue site. The cannula defines a longitudinal axis and has a longitudinal passageway for passage of a surgical object for positioning with respect to the tissue site. The housing is adapted for movement relative to the cannula in a direction transverse to the longitudinal axis. The seal has a passage for reception of the surgical object in substantial sealed relation therewith. The access assembly may further include a support member mounted to the cannula. The support member adapted to maintain a predetermined distance between the housing and the tissue. The support member may be securely affixed to, or selectively positionable along, the cannula with respect to the longitudinal axis.

CROSS REFERENCE TO RELATED APPLICATION

The present application is a continuation of U.S. application Ser. No.12/467,390, filed on May 18, 2009, which claims the benefit of andpriority to U.S. Provisional Application Ser. No. 61/076,188, filed onJun. 27, 2008, the entire contents of which are incorporated herein byreference.

BACKGROUND

1. Technical Field

The present disclosure relates generally to trocar assemblies foraccessing the body, and more particularly, to a trocar assemblyincluding a housing that may laterally translate about the proximal endof a cannula.

2. Background of Related Art

Trocars and other access assemblies are used by surgeons to operate on apatient without having to create large incisions that may becomeinfected and may cause major scaring. Trocar assemblies are known in theart, as are the instruments inserted therethrough for operating withinthe body cavity. Typically a trocar assembly comprises two majorcomponents, a sleeve including a housing and a cannula, and anobturator. The housing may be securely affixed to the cannula, or thehousing may instead be adjustable. Typically, a trocar system having anadjustable or floating housing includes a housing configured to permitlateral movement of the housing relative to the cannula. Byincorporating a floating housing into the trocar assembly an instrumentinserted through the housing may be manipulated with a greater degree ofcontrol and without moving the cannula.

In order to provide a greater space in which a surgeon may operate andto increase visibility of the tissue being operated on, the body cavityis generally insufflated. To avoid gas leakage from within the cavityprior to or during insertion of an instrument through the cannula, andas instruments are being removed and replace, various seal members havebeen developed. Conventional trocar assemblies having a floating housinginclude at least one seal member fixedly disposed within the housing.Thus, as an instrument is inserted through a trocar assembly, a seal iscreated about the instrument as it passes through the housing. In thismanner, when the housing, or the instrument inserted therethrough, ismanipulated the seal member and the housing are moved together. Byincluding the seal member within the housing the connection between thehousing and the cannula must be air-tight to prevent the leakage ofinsufflation gas. Frequent or repeated use of the trocar assembly maycompromise the integrity of the connection between the housing and thecannula. This wear on the connection may result in malfunction of theseal and result in leakage of the insufflation gas.

Additionally, the location of the seal member within the access assemblyaffects the handling of an instrument passing therethrough. The sealmember in effect creates a pivot point around which the instrument maybe manipulated. The closer the pivot point is to the target site, thegreater the degree of control a surgeon may have while manipulating theinstrument inserted therethrough. By including the seal within thehousing the pivot point is as far from the target site as possible,thereby reducing the degree of control the surgeon has over theinstrument.

Therefore, it would be beneficial to have a trocar assembly including afloating housing wherein the instrument seal is located distally of thefloating housing or within the cannula.

SUMMARY

According to an aspect of the present disclosure, a surgical accessassembly is provided. The access assembly includes a cannula adapted forinsertion through tissue to permit access to an underlying tissue site.The cannula defines a longitudinal axis and has a longitudinalpassageway for passage of a surgical object for positioning with respectto the tissue site. The access assembly also includes a housing mountedto the cannula. The housing is adapted for movement relative to thecannula in a direction transverse to the longitudinal axis. The accessassembly further includes a seal disposed within the cannula and has apassage for reception of the surgical object in substantial sealedrelation therewith.

The surgical access assembly may further include a support membermounted to the cannula. The support member is adapted to maintain apredetermined distance between the housing and the tissue. The supportmember may be securely affixed to the cannula. The support member mayinstead be selectively positionable along the cannula with respect tothe longitudinal axis.

The surgical access assembly may include a means for maintaining thesupport member at a selected position along the longitudinal axis. Thecannula and the support member may include threaded portions adapted tocooperate to selectively position the support member along the cannula.

The support member may be adapted for rotational movement relative tothe housing between a first position corresponding to a secured positionof the housing with respect to the cannula whereby the housing isprevented from moving in the direction transverse to the longitudinalaxis, and a second position corresponding to a release position of thehousing with respect to the cannula whereby the housing is permitted tomove in the direction transverse to the longitudinal axis.

The housing may further include a seal disposed across the longitudinalopening. The surgical access assembly may further include a compressiblering mounted between the cannula and the housing for maintaining thehousing relative to the cannula. The compressible ring may beconstructed of rubber or foam.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing summary, as well as the following detailed descriptionwill be better understood when read in conjunction with the appendedfigures. For the purpose of illustrating the present disclosure, apreferred embodiment is shown. It is understood, however, that thepresent disclosure is not limited to the precise arrangement andinstrumentalities shown.

FIG. 1 is a side plan view of a trocar assembly according an embodimentof the present disclosure;

FIG. 2 is a side cross-sectional view of the trocar assembly of FIG. 1;

FIG. 3A is a top view of the trocar assembly of FIGS. 1 and 2;

FIG. 3B is a cross-sectional view of the trocar assembly of FIG. 1 takenalong line 3B-3B of FIG. 1;

FIG. 3C is a cross-sectional view of the trocar assembly of FIG. 1 takenalong line 3C-3C of FIG. 1;

FIG. 4A is a cross-sectional side view of the trocar assembly of FIGS.1-3C, in a first shifted condition;

FIG. 4B is a top view of the trocar assembly of FIG. 4A;

FIG. 5A is a cross-sectional side view of the trocar assembly of FIGS.1-4B, in a second shifted condition;

FIG. 5B is a top view of the trocar assembly of FIG. 4A;

FIG. 6A is a cross-sectional side view of a trocar assembly according toan alternate embodiment of the present disclosure, with the housingshown in a first or locked position; and

FIG. 6B is a cross-sectional side vie of the trocar assembly of FIG. 6A,with the housing shown in a second or adjustable position.

DESCRIPTION OF THE EMBODIMENTS

Referring now to the drawings wherein like reference numerals illustratesimilar components throughout the several views. As shown in thedrawings and as described throughout the following description, as istraditional when referring to relative positioning on an object, theterm “proximal” refers to the end of the apparatus which is closer tothe user and the term “distal” refers to the end of the apparatus whichis further from the user.

FIGS. 1-5B illustrate a trocar assembly 100 in accordance with theprinciples of the present disclosure. Referring initially to FIG. 1,trocar assembly 100 includes a housing 102 configured to receive aproximal end 110 a of a cannula 110. As will be discussed below, housing102 is configured to move or float relative to cannula 110 in a planeperpendicular to cannula 110, thereby permitting cooperating or at leastlateral movement of an instrument E (FIG. 4A) extending therethrough.Trocar assembly 100 further includes a support member 120 secured tocannula 110 and configured for supporting housing 102 as it ismaintained relative to cannula 110. Trocar assembly 100 may beconfigured for use with any known endoscopic or laparoscopic instrument.

Turning now to FIG. 2, housing 102 forms a substantially annular memberhaving a partially closed proximal end 102 a and a partially closeddistal end 102 b. Housing 102 may instead define an oval, square,rectangular or other suitable profile. Housing 102 may be constructed ofmetal, plastic, polymer or other suitable material. Housing 102 definesa passageway 101 therethrough for receiving an instrument E (FIG. 4A).Proximal end 102 a of housing 102 defines an opening 103 configured toreceive instrument E therethrough.

Although not necessary for proper operation of trocar assembly 100,opening 103 may include a seal (not shown) for receiving instrument Etherethrough. In this manner, housing 102 may further include a port(not shown) configured to fluidly communicate with a source ofinsufflation gas (not shown). Opening 103 may be configured to receiveinstruments of various diameters and configurations. In an alternateembodiment, proximal end 102 a of housing 102 may be configured withtabs or latches (not shown) for selectively securing an instrument (notshown) to housing 102, thereby permitting greater control duringmanipulation.

Still referring to FIG. 2, distal end 102 b of housing 102 defines ahorizontal slot 105 for receiving a flange 115 formed on proximal end110 a of cannula 110. As will be discussed in further detail below,distal end 102 b of housing 102 is configured to floatingly receiveflange 105 therein. A rubber or foam ring 105 a may be included withslot 105. In the event that housing 102 is pressurized, foam ring 105 amay form a seal between the connection of housing 102 and cannula 110 toprevent leakage of the insufflation gas.

With reference still to FIG. 2, cannula 110 is configured to be insertedthrough the skin into a body cavity with the aid of an obturator (notshown) or may instead include a blade or piercing tip for penetratingthrough the skin and into a body cavity. Cannula 110 forms asubstantially tubular member having proximal and distal ends 110 a, 110b. Cannula 110 may be composed of plastic, metal, polymers or the like.Cannula 110 may be disposable, or in the alternative, reusable. Cannula110 may be rigid, or alternatively, cannula 110 may be flexible. Asdescribed above, proximal end 110 b of cannula 110 includes a flange115. Flange 115 is configured to float or move relative to housing 102within slot 105 formed in distal end 102 b thereof. Distal end 110 b ofcannula 110 may be open. Distal end 110 b may instead be configured toinclude one or more seal members (not shown).

Cannula 110 includes at least one valve or seal member 112 along thelength thereof for receiving an instrument E (FIG. 4A) therethrough.Seal member 112 defines an opening 112 a for receiving instrument Etherethrough. Opening 112 a may be sized to receive instruments of anydiameter and configuration. In an alternate embodiment, cannula 110 mayinclude a port (not shown) for fluidly communication trocar assembly 100with a source on insufflation gas.

Referring now to FIGS. 3A-3C, trocar assembly 100 includes a supportmember 120 securely affixed to proximal end 110 a of cannula 110 forsupporting housing 102 as housing 102 is moved relative to cannula 110.Support member 120 includes a substantially wheel shaped memberincluding an outer rim 122, an inner rim 124, and spindles 126 extendingtherebetween. Referring back to FIG. 2, inner rim 124 of support member120 is securely affixed to proximal end 110 a of cannula 110. Supportmember 120 may be affixed to cannula 110 using adhesive, mechanicalfasteners, friction fit, threaded members or any other suitable means.Support member 120 is positioned about cannula 110 such that distal end102 b of housing 102 rests on spindles 126. Outer rim 122 is configuredto have a diameter larger than that of housing 102. By positioninglarger support member 120 about cannula 110 in contact with housing 102adjustable positioned on proximal end 110 a, housing 102 is retained ina horizontal position as housing 102 is adjusted relative to cannula110. Spindles 120 and/or the portion of housing 102 that contactsspindles 120 may include a coating of a friction reducing material, suchas Teflon® to promote movement of housing 102 relative to cannula 110.

Turning now to FIGS. 6A and 6B, in an alternative embodiment, supportmember 220 may be configured to selectively secure housing 202 inposition relative to cannula 210. In this manner, housing 202 would belocked in position relative to housing 202 until an action by the userdisengages housing 202 from cannula 210. Housing 202 may be lockedrelative to cannula 210 with mechanical fasteners (not shown) or insteadsupport 220 may be configured, as shown, to longitudinally translatealong cannula 210, thereby permitting engagement of support 220 withhousing 202. By engaging housing 202 (FIG. 6A) support 220 preventsmovement thereof. As shown, cannula 210 and support member 220 mayinclude threads 211, 221, respectively. Threads 211, 221 may be of anysize and include any configuration. Rotation of support member 220relative to cannula 210 advances support member 220 distally alongcannula 220 into housing 202. The engagement of support member 220 withhousing 202 prevents the lateral translation of housing 202. Rotation ofsupport member 220 in an opposite direction about cannula 210 maydisengage support member 220 from housing 202, thereby permittingmovement of housing 202 relative to cannula 210 (FIG. 6B). It is alsoenvisioned that the threaded arrangement may enable the clinician toposition support member 220 at selected or predetermined positions alongcannula 210 and with respect to the longitudinal axis. Thus, supportmember 220 may space housing 202 at predetermined locations relative tothe tissue.

Turning back to FIGS. 1-5B, in operation, trocar assembly 100 isinitially inserted into a body cavity in a manner similar to knowntrocar assemblies. As discussed above, distal end 110 b of cannula 110may be configured to pierce through the skin and into the body cavity oran obturator (not shown) may be inserted through trocar assembly 100 toassist in the piercing of the skin and the creation of an opening forcannula 110 to be received through. Once received in the body cavity,the obturator, if used, may be removed, and trocar assembly 100 is readyto receive an instrument.

Referring initially to FIG. 2, in a first or initial position housing102 and cannula 110 are concentric with one another and define a centralaxis x-x. As discussed above, foam or rubber ring 105 a may be receivedwithin slot 105 formed in distal end 102 b of housing 102 to maintainhousing 102 in this first or initial position concentric with cannula110.

Referring now to FIGS. 4A-5B, trocar assembly 100 is configured toreceive an instrument E through housing 102 and cannula 110 and into abody cavity (not shown). Instrument E is typically received throughhousing 102 and cannula 110 when trocar assembly 100 is in a first orinitially position (FIG. 2), with housing 102 and cannula 110 concentricwith one another. However, instrument E may be received within trocarassembly 100 when housing 102 is non-concentric or in shifted positionrelative to cannula 110.

Referring initially to FIGS. 4A and 4B, when a user applies a lateralforce against housing 102 in a direction indicated by arrow F1, housing102 translates horizontally relative to cannula 110 in the directionforce F1. Slot 105 formed in distal end 102 b of housing 102 permitsthis movement of housing 102 relative to cannula 110. In this manner,housing 102 and thus, instrument E inserted therethrough, may bemanipulated relative to cannula 110 without moving cannula 110.Referring now to FIGS. 5A and 5B, application of a lateral force in asecond direction, indicated by arrow F2, causes housing 102 to translatehorizontally relative to cannula 110 in the direction of force F2. Asdiscussed above, slot 105 may include a rubber or foam ring 105 a thatmay compress as housing 102 is moved about cannula 110. The release offorce F1, F2 against housing 102 causes ring 105 a to decompress,thereby returning housing 102 it its initial, concentric position withcannula 110. In this manner, housing 102 may be moved any direction in ahorizontal plane relative to cannula 110. By being able to laterallymove housing 102 relative to cannula 110, a user may more preciselymanipulate and have greater control over instrument E insertedtherethrough.

It will be understood that various modifications may be made to theembodiments disclosed herein. Therefore, the above description shouldnot be construed as limiting, but merely as exemplifications ofpreferred embodiments. Those skilled in the art will envision othermodifications within the scope and spirit of the claims append hereto.

1. A surgical method, comprising the steps of: providing an access assembly including a cannula adapted for insertion through tissue to permit access to an underlying tissue site and a housing mounted to the cannula; introducing a surgical object through a longitudinal passageway communicating through the cannula and the housing, moving the housing in a direction transverse to a longitudinal axis defined by the cannula to enable angulation of the surgical object relative to the longitudinal axis; supporting the housing with a support member, the support member being mounted about the cannula and positionable to contact the housing; and establishing a seal about the surgical object.
 2. The surgical method according to claim 1 wherein the step of supporting includes moving the support member relative to the housing to a first position with respect to the cannula whereby the housing is secured and prevented from moving in the direction transverse to the longitudinal axis.
 3. The surgical method according to claim 2 including the step of releasing the housing by moving the support member to a second position with respect to the cannula whereby the housing is unsecured and permitted to move in the direction transverse to the longitudinal axis.
 4. The surgical method according to claim 3 wherein the support member is longitudinally movable along the cannula with respect to the longitudinal axis and wherein the step of supporting the housing includes moving the support member in a longitudinal direction to the first position whereby the support member engages and secures the housing to prevent the housing from moving in the direction transverse to the longitudinal axis.
 5. The surgical method according to claim 4 wherein the step of releasing the housing includes moving the support member in a longitudinal direction to the second position displaced from the housing.
 6. The surgical method according to claim 5 wherein the cannula and the support member include threaded portions and wherein the steps of supporting and releasing include selectively moving the support member along the cannula between the first and second positions thereof through effecting relative rotational movement of the cannula and the support member.
 7. The surgical method according to claim 1 including an object seal mounted to intersect the longitudinal passageway and wherein the step of establishing a seal includes positioning the surgical object within a passage of the seal whereby inner surfaces defining the passage establish a sealed relation about the surgical object.
 8. The surgical method according to claim 3 wherein the step of supporting includes rotating the support member relative to the housing to cause the support member to assume the first position corresponding to a secured position of the housing to prevent the housing from moving in the direction transverse to the longitudinal axis.
 9. The surgical method according to claim 8 wherein the step of releasing includes rotating the support member relative to the housing and about the longitudinal axis to cause the support member to assume the second position corresponding to a release position of the housing with respect to the cannula to permit the housing to move in the transverse to the longitudinal axis.
 10. A surgical method, comprising the steps of: providing an access assembly including a cannula adapted for insertion through tissue to permit access to an underlying tissue site and a housing mounted to the cannula; introducing a surgical object through an opening of the housing and through a longitudinal passageway of the cannula, moving the housing in a direction transverse to a longitudinal axis defined by the cannula from a first position where the opening is axially aligned with the longitudinal axis of the cannula to a second position where the opening is axially offset relative to the longitudinal axis; securing the housing in at least one of the first and second positions; and establishing a seal about the surgical object.
 11. The surgical method according to claim 10 including a support member mounted about the cannula and movable in a longitudinal direction with respect to the longitudinal axis and wherein the step of securing includes longitudinal moving the support member to an approximated position with respect to the housing.
 12. The surgical method according to claim 11 including the step of releasing the housing to permit traversing movement thereof by longitudinally moving the support member to a displaced position with respect to the housing. 